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Updated: Nov 5, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
The renal microcirculation in chronic kidney disease: novel diagnostic methods and therapeutic perspectives
Shulin Li1, Fei Wang1, Dong Sun2,3
1Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, 99 West Huai-hai Road, Xuzhou, 221002, Jiangsu, China.
Abstract:
Chronic kidney disease (CKD) affects 8-16% of the population worldwide and is characterized by fibrotic processes. Understanding the cellular and molecular mechanisms underpinning renal fibrosis is critical to the development of new therapeutics. Microvascular injury is considered an important contributor to renal progressive diseases. Vascular endothelium plays a significant role in responding to physical and chemical signals by generating factors that help maintain normal vascular tone, inhibit leukocyte adhesion and platelet aggregation, and suppress smooth muscle cell proliferation. Loss of the rich capillary network results in endothelial dysfunction, hypoxia, and inflammatory and oxidative effects and further leads to the imbalance of pro- and antiangiogenic factors, endothelial cell apoptosis and endothelial-mesenchymal transition. New techniques, including both invasive and noninvasive techniques, offer multiple methods to observe and monitor renal microcirculation and guide targeted therapeutic strategies. A better understanding of the role of endothelium in CKD will help in the development of effective interventions for renal microcirculation improvement. This review focuses on the role of microvascular injury in CKD, the methods to detect microvessels and the novel treatments to ameliorate renal fibrosis.
Insights
Chronic kidney disease (CKD) involves microvascular injury, leading to renal fibrosis. This review explores endothelial dysfunction in CKD and therapeutic strategies to improve renal microcirculation.
Area of Science:
- Nephrology
- Vascular Biology
- Cellular Biology
Background:
- Chronic kidney disease (CKD) affects 8-16% globally, characterized by renal fibrosis.
- Microvascular injury is a key driver of progressive kidney disease.
- Endothelial cells are crucial for maintaining vascular homeostasis and responding to injury.
Purpose of the Study:
- To review the role of microvascular injury in CKD pathogenesis.
- To discuss methods for detecting and monitoring renal microcirculation.
- To explore novel therapeutic strategies for ameliorating renal fibrosis by targeting the endothelium.
Main Methods:
- Literature review focusing on renal fibrosis, microvascular injury, and endothelial dysfunction in CKD.
- Analysis of current and emerging techniques for assessing renal microcirculation.
- Synthesis of data on therapeutic interventions aimed at improving endothelial function and reducing fibrosis.
Main Results:
- Endothelial dysfunction, hypoxia, inflammation, and apoptosis contribute to renal fibrosis.
- Loss of capillary networks exacerbates CKD progression.
- Advanced imaging and monitoring techniques offer new ways to assess microvascular health.
Conclusions:
- Targeting microvascular injury and improving endothelial function are promising therapeutic avenues for CKD.
- Understanding the endothelium's role is critical for developing effective anti-fibrotic strategies.
- Novel treatments focusing on renal microcirculation hold potential for managing CKD progression.
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